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NDC 1191721550

POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER

Reported by 20 hospitals in the network.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

National pricing summary

Low

$23

Average

$31

Median

$31

High

$41

Hospitals reporting this code

#HospitalLocation
1Catholic Health Initiatives ColoradoColorado Springs, CO$12$24$26$45$10
2Catholic Health Initiatives ColoradoSalt Lake City, UT$18$27$31$51$9
3Catholic Health Initiatives ColoradoColorado Springs, CO$14$25$29$45$10
4Catholic Health Initiatives ColoradoLehi, UT$18$27$31$51$9
5St Francis HospitalColorado Springs, CO$12$23$25$43$9
6Longmont United HospitalLongmont, CO$12$20$25$46$11
7Catholic Health Initiatives ColoradoFrisco, CO$14$30$33$47$11
8Commonspirit Kansas, Inc.Ulysses, KS$16$42$35$48$13
9Commonspirit Kansas, Inc.Dodge City, KS$18$40$39$46$7
10Catholic Health Initiatives ColoradoPueblo, CO$14$29$30$45$10
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